| NPI | 1427003771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 240) |
| Additional Taxonomies | 101YP1600X Counselor, Pastoral (Licence: WV 240) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 240) | |
| 101Y00000X Counselor (Licence: WV 240) | |
| 101YM0800X Counselor, Mental Health (Licence: WV 240) | |
| 101YP2500X Counselor, Professional (Licence: KY 244983) | |
| 101YP2500X Counselor, Professional (Licence: OH E.1901384) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2026-08-04 |